Tryptophan, Serotonin and Kynurenine in Septic Shock

Inclusion criteria

• Age above or equal to 18 years
• Strong presumption clinical sepsis
• Need for mechanical ventilation
• Body temperature above 38°C or below 36°C
• Heart rate above 90 bpm
• Systolic blood pressure of <90mm Hg despite adequate fluid replacement or a need for vasopressors less than 3 hours
• Presence of at least one of the following criteria:

• Ratio of arterial oxygen tension over inspired fraction of oxygen of less than 300 mm Hg
• Urinary output below 0.5 mL per kg of bodyweight per h or below 30 mL/h (for at least 1 h)
• Arterial lactate concentration above 2 mmol/L
• Consent signed

Exclusion criteria

• Age below 18 years
• Pregnancy
• Underlying disease with a poor prognosis, a life expectancy of less than 24 hours
• Depression or melancholy
• Neuropsychiatric diseases: Seizure, manic psychosis, Migraine, or Drug addiction
• Neuroendocrine tumors
• Obstructive cardiomyopathy or acute myocardial ischaemia
• Pulmonary embolism
• Advanced stage cancer, malignant haemopathy, or AIDS with a decision to withhold or withdraw aggressive therapies
• Inclusion in another clinical trial
• Patient who receive before inclusion one of the following treatment known to modify serotonin level: almotriptan, amitriptyline, amoxapine, citalopram, clomipramine, clozapine, desipramine, dihydroergotamine, dolasetron, dosulepin, doxepin, eletriptan, ergotamine, flunarizine, fluoxetine, fluvoxamine, granisetron, imipramine, indoramin, interferon Alfa, interferon alfacon-1, interferon beta, iproniazid, maprotiline, methysergide, mianserin, Milnacipran, mirtazapine, moclobemide, naratriptan, olanzapine, ondansetron, oxetorone, paroxetine, pizotifen, risperidone, sertraline, sumatriptan, tianeptine, trimipramine, tropisetron, venlafaxine,viloxazine, zolmitriptan.
• No consent